Puddle Question: What Killed Alexander the Great?

Those who teach grade-school level math or science are familiar with the concept of a ‘puddle question’. These are usually word problems of some sort which have more than one possible answer. From a teacher point of view, they are designed to assess how a student approaches a problem, comes up with a plan, then solves the problem. They tend to be ‘strange’ things in a math class like “How many raindrops make up a puddle?” (whence comes the name of this type of question) or “How many hours have you spent watching TV your entire life?” In Ancient History, we also have puddle questions, although not known by that name, and possibly the most common/famous one relates to “solving” why Alexander the Great died. Today, Discovery News presents a completely new theory, related to a bacterium from the Styx. Here are some excerpts:

An extraordinarily toxic bacterium harbored by the “infernal” Styx River might have been the fabled poison rumored to have killed Alexander the Great (356 – 323 B.C.) more than 2,000 years ago, according to a scientific-meets-mythic detective study.

[…]

“Indeed, no ancient writer ever casts doubt on the existence of a deadly poison from the Styx River,” Mayor, author of the Mithradates biography “The Poison King,” said.

The researchers believe this mythic poison must be calicheamicin. “This is an extremely toxic, gram-positive soil bacterium and has only recently come to the attention of modern science. It was discovered in the 1980s in caliche, crusty deposits of calcium carbonate that form on limestone and is common in Greece,” author Antoinette Hayes, toxicologist at Pfizer Research, told Discovery News.

Now called Mavroneri, “Black Water,” the Styx originates in the high mountains of Achaia, Greece. Its cold waters cascade over a limestone crag to form the second highest waterfall in Greece.

“Unfortunately, the geochemistry of the river has not yet been studied by modern scientists; therefore, there is no scientific data to support the plausible and interesting calicheamicin theory,” Walter D’Alessandro, hydro-geochemist at the Italian National Institute of Geophysics and Volcanology in Palermo, told Discovery News.

Whether Alexander really died from poisoning, as some of his closest friends believed, is pure speculation, Mayor and Hayes concede.

“We are not claiming that this was the poison that killed Alexander, nor we are arguing for or against a poison plot,” Mayor said.

[…]

Retrodiagnoses for his mysterious death have included poisoning, heavy drinking, septicemia, pancreatitis, malaria, West Nile fever, typhoid, and accidental or deliberate poisoning (hellebore, arsenic, aconite, strychnine).

“Notably, some of Alexander’s symptoms and course of illness seem to match ancient Greek myths associated with the Styx. He even lost his voice, like the gods who fell into a coma-like state after drinking from the river,” Mayor said.

The poisoning diagnoses were rejected by many experts because few poisons induce fever. Furthermore, even fewer such poisons were available in Alexander’s time.

However, naturally occurring calicheamicin, which is extremely cytotoxic, could still be the culprit.

“Cytotoxins cause cell death and induce high fever, chills, and severe muscle and neurological pain. Therefore, this toxin could have caused the fever and pain that Alexander suffered,” Hayes said.

According to Richard Stoneman, the foremost expert on the myths of Alexander, the theory offers a good explanation for the Styx’s ancient reputation.

“I personally think that Alexander probably died of natural causes — either typhoid or an overdose of the hellebore used to treat his illness — but other views are possible,” Stoneman, author of “A Life in Legend: Alexander the Great,” told Discovery News.

Back in December of 2004, when West Nile Virus was being suggested as a possible cause of Alexander’s death, I said I would present a summary of the various theories ‘after Christmas’. I don’t appear to have actually ever done that but, fortunately for me, in the mean time an incredibly excellent article on the subject has appear in the January issue of Acta Classica and it’s online at the Free Library:

In brief, it presents Alexander’s symptoms, provides a timeline of what happened when according to the ancient sources, and then has an incredibly useful appendix of all the proposed causes of death and their merits or lack thereof. Just to give you an idea of the things that have been proposed:

malaria

alcohol-related problems (this one seems to be the most popular current belief, to judge from some Twitter reactions to the Discovery.com article; recent movies probably contribute to this view)

typhoid fever

West Nile Virus/encephalitis

Schistosomiasis

some water-bourne illness leading to pneumonia

Whatever the case, both the Discovery article and the Acta Classica one are must reading …

rogueclassicism: 1. n. an abnormal state or condition resulting from the forced migration from a lengthy Classical education into a profoundly unClassical world; 2. n. a blog about Ancient Greece and Rome compiled by one so afflicted (v. "rogueclassicist"); 3. n. a Classics blog.